Significance of protease-activated receptor-2 in the development of post-ERCP pancreatitis

Protease activated receptor-2 (PAR-2) is expressed in both the pancreatic duct cells and pancreatic acinar cells in the condition of pancreatic injury, promotes pancreatic secretion, and protects the pancreas by detoxification. In post-ERCP pancreatitis (PEP), the activation of trypsin induces PAR-2 activation for the protection of the pancreas. However, in the case with the obstruction of the duodenal papilla PAR-2 activation brings resultant ductal hypertension, and exacerbates pancreatitis. Thus, proper pancreatic duct drainage is reasonable approach for the prevention and protection from the aggravation of PEP.